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Weight Assessment

Please ensure you enter accurate height and weight details as this may affect future prescribing decisions

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Your BMI:

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About You

About Your Health

  • Any serious condition which may require immediate hospitalisation
  • Chronic malabsorption syndrome
  • Eating disorders
  • Liver problems
  • Pancreas problems
  • Active Gall bladder problems
  • Type 1 diabetes
  • Thyroid cancer
  • Asthma
  • Chronic back pain
  • Fatty liver disease
  • Gout
  • Heart disease
  • High cholesterol
  • Osteoarthritis
  • Polycystic Ovarian Syndrome (PCOS)
  • Sleep apnoea

About Your Medications

About Your Agreement

  • You have answered the above questions accurately and honestly.
  • You have capacity to understand all about the condition and the treatments available here.
  • The treatment for your own use only.
  • You have read and understood what the treatment options / benefits / risks and side effects associated with them.
  • You agree to read the patient information leaflet before taking the treatment and use the treatment as directed.
  • You will contact your doctor if you experience any adverse effects or symptoms change.
  • You understand there may be an increased risk of pancreatitis / gall bladder problems / gall stones with using the weight loss injectable treatments so if you experience any abdominal pain whilst using them you should consult your doctor.
  • You understand that if you are a woman of childbearing potential you should use effective contraception during and for at least 2 months after stopping weight loss injectable treatments.
  • You agree that in order to obtain the best weight loss results it important to incorporate a healthy balanced diet and exercise with the treatment.
  • You agree to send photographic evidence upon request to verify your weight status.
  • You agree to inform your GP of this treatment if it is prescribed to you in order to ensure your medical records are complete. This can be done by downloading your GP letter from "My Orders".